scholarly journals Risk Evaluation of Endoscopic Retrograde Cholangiopancreatography-Related Contrast Media Allergic-Like Reaction: A Single Centre Experience

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Félix Trottier-Tellier ◽  
Laurence Harvey ◽  
Jean-Daniel Baillargeon
Keyword(s):  
At Risk ◽  
Adverse Reaction ◽  
Contrast Media ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Adverse Reactions ◽  
Past History ◽  
Retrospective Chart Review ◽  
Single Centre ◽  
Endoscopic Retrograde ◽  
Few Data

Background and Aims.Few cases of endoscopic retrograde cholangiopancreatography- (ERCP-) related contrast media (CM) adverse reactions have been reported in the current literature. There is a lack of standardisation in practice regarding premedication prophylaxis for at-risk patients undergoing ERCP and there are few data to guide the practitioners. Our goal is to evaluate the risk of CM adverse reaction in a group of patients with a past history of allergic-like reaction to iodine product undergoing ERCP.Methods.A retrospective chart review study was performed of patients who underwent ERCP at our single centre from January 2010 to December 2015.Results.2295 ERCPs were performed among 1766 patients. No anaphylactoid or severe adverse reaction occurred. One (0.04%) ERCP-related CM benign reaction was reported in a patient known for penicillin allergy. Among 127 ERCPs performed on patients with a prior adverse reaction to iodine, 121 procedures were done without and 6 with a premedication prophylaxis. In both groups, no ERCP-related CM reaction occurred.Conclusions.To our knowledge, we report the largest cohort of iodine allergic patients undergoing ERCP ever published. These results suggest that ERCP-related CM adverse reactions are very rare even among patients at risk for CM reaction.

Efficacy of an Oxycodone-Propofol Combination versus a Fentanyl-Propofol Combination in Conscious Sedation during Therapeutic Endoscopic Retrograde Cholangiopancreatography in Elderly Patients

Gerontology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Peipei Guo ◽  
Huisheng Wu ◽  
Lan Liu ◽  
Qiu Zhao ◽  
Zhao Jin
Keyword(s):  
Adverse Events ◽  
Elderly Patients ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Postoperative Nausea ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Conscious Sedation ◽  
Endoscopic Retrograde ◽  
Patients Satisfaction ◽  
Low Incidence

<b><i>Background:</i></b> With a rapidly aging population, the need for endoscopic retrograde cholangiopancreatography (ERCP) is increasing. The commonly used sedation anesthesia in ERCP is a combination of propofol and fentanyl, even though fentanyl may cause some adverse reactions such as respiratory depression. <b><i>Objectives:</i></b> This study aimed to evaluate the efficacy of oxycodone combined with propofol versus fentanyl combined with propofol for sedation anesthesia during ERCP. <b><i>Methods:</i></b> A total of 193 patients aged from 65 to 80 years undergoing ERCP were enrolled and randomized into two groups: an “oxycodone combined with propofol” group (group OP, <i>n</i> = 97) and a “fentanyl combined with propofol” group (group FP, <i>n</i> = 96). The rate of perioperative adverse events as well as the recovery time, patients’ satisfaction, and endoscopists’ satisfaction were noted. <b><i>Results:</i></b> There was no difference in the frequency of hypotension or bradycardia between the two groups, but there were more episodes of desaturation (SpO<sub>2</sub> &#x3c;90% for &#x3e;10 s in 8.3%), postoperative nausea (7.3%), and vomiting (5.2%) in group FP than in group OP. Patients’ satisfaction in group FP was lower than that in group OP. The recovery time was longer in group FP than in group OP. <b><i>Conclusions:</i></b> Oxycodone combined with propofol was effective in ERCP, with a low incidence of perioperative adverse events.

scholarly journals EUS-directed transgastric endoscopic retrograde cholangiopancreatography versus laparoscopic-assisted ERCP versus deep enteroscopy-assisted ERCP for patients with RYGB

2020 ◽  
Vol 08 (07) ◽  
pp. E877-E882 ◽  
Author(s):  
Gursimran S. Kochhar ◽  
Nabeeha Mohy-ud-din ◽  
Abhinav Grover ◽  
Neil Carleton ◽  
Abhijit Kulkarni ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Retrospective Chart Review ◽  
Complication Rates ◽  
Success Rates ◽  
Technical Success ◽  
Endoscopic Retrograde ◽  
Technical Success Rate ◽  
Edge Group ◽  
History Of ◽  
Laparoscopic Assisted

Abstract Background and study aims Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) (EDGE) is a novel technique for managing pancreaticobiliary diseases in patients with a history of Roux-en-Y Gastric Bypass (RYGB). It has shown to have high technical success rates and fewer adverse events as compared to laparoscopic-assisted ERCP (LA-ERCP). We compared the technical success and clinical outcomes of EDGE vs. LA-ERCP vs. E-ERCP. Patients and methods A retrospective chart review was performed for 56 patients, of whom 18 underwent LA-ERCP, 12 underwent E-ERCP, and 26 had EDGE, and a comparison of technical success and complication rates was done. Results Baseline demographic characteristics of patients undergoing these procedures, including age and gender, were comparable. The technical success rate for patients in the EDGE group were 100 % (n = 26), compared with 94 % (n = 17) and 75 % (n = 9) in the LA-ERCP and E-ERCP groups (P = 0.02). In the EDGE group, 8 % of patients (n = 2) had bleeding, and 4 % of patients (n = 1) had lumen-apposing metal stent migration occur during the procedure. In the LA-ERCP group 6 % (n = 1) of patient had bleeding, 6 % (n = 1) post-ERCP pancreatitis and 6 % (n = 1) were diagnosed with an intra-abdominal infection post-procedure. Time to complete the EDGE procedure was significantly shorter at 79 ± 31 mins, compared with 158 ± 50 mins for LA-ERCP and 102 ± 43 mins for E-ERCP (P < 0.001). Conclusion EDGE is a novel procedure with short procedure times and an effective alternative to LA-ERCP and E-ERCP in management of pancreaticobiliary diseases in patients with a history of RYGB.

Short 5Fr vs Long 3Fr Pancreatic Stents in Patients at Risk for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

2009 ◽  
Vol 7 (8) ◽  
pp. 834-839 ◽  
Author(s):  
Prabhleen Chahal ◽  
Paul R. Tarnasky ◽  
Bret T. Petersen ◽  
Mark D. Topazian ◽  
Michael J. Levy ◽  
...  
Keyword(s):  
At Risk ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Patients At Risk

Safety of gastrointestinal endoscopy during pregnancy

2011 ◽  
Vol 152 (26) ◽  
pp. 1043-1051 ◽  
Author(s):  
András Taller
Keyword(s):  
Radiation Exposure ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Gastrointestinal Endoscopy ◽  
Case Reports ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Endoscopic Retrograde ◽  
Fecal Occult ◽  
Physiological Changes In Pregnancy ◽  
Few Data

There are only few data of gastrointestinal endoscopy in pregnant patients. Only 0.4% of all procedures are carried out during pregnancy. Case reports and some small retrospective studies are available. Because of physiological changes in pregnancy there might be special risks of endoscopy. There might be complaints which can be physiologic during pregnancy, but can be signs of gastrointestinal disorders, too. Therefore, indications for endoscopy are not always clear and easy. Safety of the procedures is also not well studied. Besides the risks of endoscopy, medication given to the mother, electrocoagulation and radiation exposure from fluoroscopy during endoscopic retrograde cholangiopancreatography might be harmful to the fetus. Endoscopy should only be done when indication is unquestionable and strong. Only FDA „A” and „B” category medication is allowed. Gastroscopy is necessary for bleeding and for patients with pyrosis going together with alarm signs. Nausea, vomiting, abdominal pain and fecal occult blood test positivity are not indications for endoscopy, only for gastroenterogical consultation. Sigmoidoscopy is recommended for indication of lower gastrointestinal bleeding and sigmoid or rectal mass. Only therapeutic endoscopic retrograde cholangiopancreatography should be performed. Obstructive jaundice and biliary pancreatitis need immediate endoscopic intervention. The fetus must be shielded from radiation exposure. Orv. Hetil., 2011, 152, 1043–1051.

scholarly journals Difference in Total Serum Immunoglobulin E Level Among Patients With and Without Intravenous Contrast Media Adverse Reaction on Computed Tomography Scan Examination

2019 ◽  
Vol 2 (1) ◽  
pp. 10-14
Author(s):  
Yulikha Ikhmawati ◽  
Zuhrial Zubir ◽  
Elvita Rahmi Daulay
Keyword(s):  
Computed Tomography ◽  
Adverse Reaction ◽  
Contrast Media ◽  
Adverse Reactions ◽  
Immunoglobulin E ◽  
Total Serum ◽  
Intravenous Contrast ◽  
Cross Sectional ◽  
Serum Ige ◽  
Intravenous Contrast Media

The adverse reaction (AR) to intravenous contrast media (ICM) are relatively common. Various opinions pro-posed in the mechanism of the incidence of ICM AR. Suspected that the role of Immunoglobulin E (IgE) me-diates allergic conditions that are part of the AR. Objective:To determine the difference in total serum IgE level  among subjects with and without ICM AR on computed tomography (CT) scan examination. To ob-serve difference in total serum IgE levels in subjects undergoing ICM adverse reaction based on the degree of severity. Method: An analytical study with cross-sectional design of 104 subjects undergoing CT scans with ICM, examined IgE levels before and after ICM was administered, then measured the severity of adverse  re-actions of contrast media. Result: In this study, subjects undergoing adverse reactions, prior to administration Iopamidol  had a higher mean IgE 1270.79 mg / dl compared with those who having AR  1174.90 mg / dl and after administration of Iopamidol  a mean of Ig E is still higher in subjects having AR  1507.96 mg/dl com-pared with those having negative AR that is 1325.88 mg/dl, p = 0.696, statistically, not significant. Mild reac-tions in 40 subjects (38.5%) with cough, nausea, dizziness, itching, and sweating. Conclusion: Increase in total IgE levels in subjects with positive adverse reactions are independent(p=0.696).

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